Onkologischer Schwerpunkt

Großhansdorf, Germany

Onkologischer Schwerpunkt

Großhansdorf, Germany
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Knopf M.,Onkologischer Schwerpunkt | Reck M.,Onkologischer Schwerpunkt
Pneumologe | Year: 2012

Within the recent years firstline therapy of advanced non-small cell lung cancer (stage III/IV) has become more specific and complex. New cytotoxic agents have been developed and new predictive factors like the EGFR mutation or specific histological markers were identified to optimize treatment outcomes. Furthermore new treatment lines like maintenance treatment have been established. This approach is going continued by identification of new biomarkers and relevant oncogenic alterations. This review will summarize current state of the art in firstline therapy of advanced NSCLC. © 2012 Springer-Verlag.

Franzen A.M.,HNO Plastische Operationen | Schneider C.,Onkologischer Schwerpunkt | Lebentrau S.,Klinik fur Urologie und Kinderurologie | Gunzel T.,Borromaus Hospital
Laryngo- Rhino- Otologie | Year: 2015

Background: Single case reports about extranodal renal cell carcinoma (RCC) metastasis to the head and neck (HN) often implicating unusual clinical follow-ups are well known. Subject of our investigation is to ascertain the true meaning of RCC for differential diagnostic of the head and neck surgion. Methods: We retrospectively review the reports of 612 patients with RCC treated in a 13-years period in the department of urology. Results: Of the 612 RCC 191 (31%) were metastatic, 3 female and 4 male (mean 66.8a, 56a-78a) presented with extranodal metastases within the HN. Extranodal locations were parotid and thyroid glands (2 ×), tongue, forehead scin, bone and paranasal sinus. Occurrence of metastases were observed in mean 40.8 months (5-87) after the primary. In one patient metastasis to the parotid gland was the only manifestation of RCC 78 month treated before, the others presented with further metastases to infraclavicular organs. Discussion: According to our results extranodal metastases of RCC to the HN are uncommon (1.1%). Therefore and because of the unusual location extranodal metastases of RCC remain a diagnostic challenge for the ENT specialist and the pathologist with peculiar knowledge of the oncological history of the patient remaining an essential condition. We found exclusive metastasis to the HN in only one of 7 cases. Nevertheless surgical treatment has to be considered in curative and symptomatic treatment strategies. © Georg Thieme Verlag KG Stuttgart · New York.

Heigener D.F.,Onkologischer Schwerpunkt
Atemwegs- und Lungenkrankheiten | Year: 2012

Approximately 50% of pulmonary adenocarcinomas seem to harbor so-called "driver" mutations, which are potentially treatable. kRAS is the most frequent alteration. However, for this and many others, no proven therapeutic approach exists yet. The majority of non-small-cell lung cancers however do not harbor such a mutation. In some of these tumors, EGFR over-expression poses a potential target to treatment with cetuximab. Other molecular targets like IGFR are in different stages of clinical development. © 2012 Dustri-Verlag Dr. Karl Feistle.

Heigener D.F.,Onkologischer Schwerpunkt
Atemwegs- und Lungenkrankheiten | Year: 2012

The discovery of the EML4 ALK translocation resulted in a targeted therapy within 3 years from first description. The drug crizotinib results in dramatic responses in patients harboring this molecular alteration. However, the prevalence of ALK translocation in NSCLC is small, so only few patients will benefit from this approach. As with anti-EGFR therapy, acquired resistance is described. Drugs overcoming this problem are in development. © 2012 Dustri-Verlag Dr. Karl Feistle.

Reinmuth N.,Thoraxklinik des Universitatsklinikums Heidelberg | Heigener D.,Onkologischer Schwerpunkt | Reck M.,Onkologischer Schwerpunkt
Atemwegs- und Lungenkrankheiten | Year: 2012

Within the last years, the therapeutic concept of anti-angiogenesis has been evaluated in non-small cell lung cancer (NSCLC). The anti-VEGF monoclonal antibody bevacizumab has been approved in combination with platinum-based chemotherapy for firstline therapy of locally advanced or metastatic NSCLC excluding predominant squamous cell histology. Moreover, various small-molecular multi-tyrosine kinase inhibitors and vascular disrupting agents are being tested in clinical studies. In the following, the concepts of these anti-angiogenic therapeutic approaches are reflected. © 2012 Dustri-Verlag Dr. Karl Feistle.

Reck M.,Onkologischer Schwerpunkt | Gutzmer R.,Klinik und Poliklinik fur Dermatologie
Onkologie | Year: 2010

The epidermal growth factor receptor (EGFR) is expressed in a variety of human tissues and is a key mediator of numerous cellular processes. Dysregulation and overexpression of the EGFR are common features of many tumors; targeted EGFR inhibitors are therefore widely employed as therapeutic agents. Novel mechanisms associated with EGFR inhibitors induce characteristic toxicities, of which cutaneous side effects (generally termed 'skin rash') are the most common. Although this rash is generally mild to moderate in severity, it can affect compliance and/or result in dose reductions or treatmentwithdrawal. To ensure that patients can continue to receive active treatment at the optimal dose, effective treatment strategies are required to actively manage rash and aid compliance. This is important as rash is increasingly identified as a predictive marker of benefit with EGFR inhibitors. The incidence and clinical characteristics of rash, in addition to current rash management strategies, are reviewed. Our recommendations based on clinical experience are presented, with two case studies of successful rash management provided to illustrate their success. Active rash management can effectively resolve rash to ensure that patient compliance is maintained, without necessitating dose interruptions or treatment withdrawal. Copyright © 2010 S. Karger AG, Basel.

Nehls W.,Klinik fur Pneumologie | Heigener D.F.,Onkologischer Schwerpunkt
Pneumologe | Year: 2016

Palliative medicine is inseparably linked to pulmonology because of the many incurable diseases with limited life expectancy in this field. Skills, such as communication for breaking bad news as well as shared decision-making are mandatory for doctors working in this field. Beyond that, knowledge of symptom control in addition to causal therapy for dyspnea, pain and other symptoms is also necessary. © 2015, Springer-Verlag Berlin Heidelberg.

We report on a 61-year-old male patient who was admitted due to dysphagia, hoarseness and stridor. CT showed extensive metastasis to the thyroid and left adrenal gland. Histology revealed small-cell lung cancer. A primary tumour could not be detected in the lungs and mediastinum. Good symptom control could be achieved by administration of platinum-based chemotherapy. © Georg Thieme Verlag KG Stuttgart · New York.

Heigener D.F.,Onkologischer Schwerpunkt | Horn M.,Onkologischer Schwerpunkt | Reck M.,Onkologischer Schwerpunkt
Internist | Year: 2016

Between 10 and 15 % of non-small cell lung cancers (NSCLC) proliferate due to the presence of a so-called driver mutation. This molecular alteration allows the cancer to continue to proliferate and can be deliberately inhibited. In addition to mutations in the epidermal growth factor receptor gene (EGFR) and translocations between the echinoderm microtubule-associated protein-like 4 gene (EML 4) and the anaplastic lymphoma kinase gene (ALK), this applies to ROS1 gene translocations. For the former two alterations, many inhibitors are already available, whereas for ROS1 and other driving mutations the evidence is sparse due to the rare occurrence of these mutations in NSCLC. © 2016 Springer-Verlag Berlin Heidelberg

Reinmuth N.,Onkologischer Schwerpunkt | Tufman A.,Ludwig Maximilians University of Munich | Steins M.,Thoraxklinik am Universitatsklinikum Heidelberg | Reck M.,Onkologischer Schwerpunkt
Onkologe | Year: 2014

Background: The majority of patients with non-small cell lung cancer (NSCLC) will receive systemic therapy for treatment of their disease.Objective: Current developments for systemic therapy of patients with metastatic non-small cell lung cancer are summmarised.Materials and methods: Description, analysis and discussion of recent clinical studies with consideration of national and international treatment guidelines.Results: In contrast to the 1990s, the treatment options for systemic therapy have considerably evolved including new anti-neoplastic drugs, agents targeting specific molecular alterations and new treatment modalities such as maintenance therapy and immunotherapy. Consequently, preselection of patients by defined clinical, histological and molecular parameters now has a central role for planning diagnostic procedures and assessing therapeutic strategies.Conclusion: For every patient, the applicable profile of molecular alterations should be assessed. Appropriate therapeutic options need to be individually duscussed. © 2014, Springer-Verlag Berlin Heidelberg.

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